Dawbarn’s Test

What is Dawbarn’s Test?

The dawbarn’s test indicates signs of subacromial bursitis.

Before understanding the procedure of performing the dawbarn’s test, you’ll first have to understand what is subacromial bursitis. And for understanding subacromial bursitis you’ll first have to understand what is subacromial bursa.

What is Subacromial Bursa and Subacromial bursitis?

Bursa is a small, fluid-filled sac located between tissues (bones, skin, joints, tendons, and muscles). Due to that fluid, the bursa can be used as a cushion between bones, skin, joints, tendons, and muscles. This help in reducing the irritation and friction between the tissues that move against each other.

When the subacromial bursa is not irritated, bones and joints move smoothly and pain-free. But when it becomes inflamed or swollen, this condition is known as subacromial bursitis.

Now How this Dawbarn’s test indicates subacromial bursitis?

People who are in the habit of traveling or engaged in any such occupational work where they have to raise their hand above their heads regularly. For example, people who travel in buses and local trains without being seated will have to catch hold of these rods while traveling.

Suppose people have a habit of traveling with their hands above their heads. In that case, this subacromial bursa will stay compressed below this coracoacromial arch and acromion for a longer period of time.

As this subacromial bursa will remain compressed for a longer period of time. Therefore due to this compression of the subacromial bursa for a longer period of time, the subacromial bursa will undergo inflammation, which is called subacromial bursitis.

So this person later on in life (after some time) will come up with the complaint of painful abduction of the shoulder joint.

Initial abduction will not be much painful because this bursa does not get compressed initially. But when the patient’s hand reaches around 90 degrees of abduction, this subacromial bursa gets compressed. As this bursa is inflamed, a test is done to check this subacromial bursitis. And that test is known as Dawbarn’s test.

Now let’s understand the procedure of performing Dawbarn’s Test.

Procedure of performing the Dawbarn’s Test

  • You’ll first have to palpate the patient’s acromion. As acromion is the lateral most bony prominence on the shoulder.
  • When you palpate upon the acromion, below this acromion, you need to give a deep press upon that. When you do that, there will be rinsing on the patient’s face due to tenderness because the subacromial bursa is inflamed.
  • Now after that, the examiner will passively abduct the patient’s arm to 90 degrees, and the examiner will again press on that point (below to the acromion). Now, after palpating just below the acromion, (again at the same point), the examiner will give a deep pressure now. But this time, there will be no pain. Because, when you abduct your hand, the bursa along with the head of humerus is gone inside the acromian and coracoacromial arch.
  • So the pain will be in a normal position, but when the patient’s hand is abducted at 90 degrees, the pain at the same point disappears. This is called a positive dawbarns’s sign. That is a check for subacromial bursitis.

Dawbarn's-testIn conclusion

When the arm is in an abduction position, and we apply pressure just below the acromion, the inflamed subacromial bursa comes in contact with the finger and the pain is felt.

But when the arm is abducted at 90 degrees, the subacromial bursa gets slips under the acromion process and coracoacromial arch. And applying pressure at the same point will not elicit pain.

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Resources

Clinical Tests for the Musculoskeletal System: Examinations-Signs-Phenomena by K. Buckup

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